ABSTRACT: Systemic sclerosis (SSc) is the disease that causes various symptoms caused by the interaction of fibrosis, inflammation, and vasculopathy. SSc has various complications, including reflux esophagitis, pulmonary hypertension, renal lesions, and interstitial lung disease (ILD). ILD associated with SSc (SSc-ILD) is the most common SSc complication with a high mortality rate. Several treatments, including immunosuppressants, antifibrotic agents, and biologics, have been investigated for SSc-ILD. Mycophenolate mofetil, nintedanib, rituximab, and tocilizumab have recently been attracting attention for their efficacy in SSc-ILD. However, the management of SSc-ILD has remained challenging, and adverse treatment events must be considered. Therefore, a better understanding of the current evidence of treatments for patients with SSc-ILD is required. In this study, we outlined the characteristics of the current treatments for SSc-ILD in terms of efficacy and safety, focusing on key existing studies.

Introduction: This study investigated retinal sensitivity around the macula using MP-3 microperimetry before and after macular hole (MH) surgery and assessed the correlation between retinal sensitivity and structural MH parameters measured by optical coherence tomography.

Methods: This retrospective study included 24 eyes with idiopathic MH (68±6.73 years, 13 men) who underwent vitrectomy between April 2020 and November 2023. MP-3 examinations were conducted preoperatively and at 3 months (24 eyes) and 12 months (16 eyes) postoperatively. Forty-five points arranged at the fovea center and within an 8° diameter were divided into concentric circles with distances of 0.5°, 1°, 2°, 3°, and 4° from the fovea, labeled as S0, S0.5, S1, S2, S3, and S4, respectively. The MH minimum linear diameter (MD) and basal diameter (BD) were measured, and their correlation with the MP-3 results was evaluated.

Results: Sensitivity up to S3 was significantly improved from preoperatively to 3 months postoperatively (S0: 9.38±8.41 to 22.63±3.29 dB, p < 0.0001; S0.5: 11.07±6.47 to 21.25±3.86 dB, p < 0.0001; S1: 13.26±5.62 to 21.19±3.22 dB, p < 0.0001; S2: 19.66±3.98 dB to 23.42±2.66 dB, p < 0.0002; S3: 22.95±3.31 to 25.01±3.16 dB, p = 0.0355). No significant improvements were observed between 3 and 12 months.

The MH size was 286±184.84 μm for MD and 685.79±333.17 μm for BD; there was a significant correlation with S0.5-S4 preoperative retinal sensitivity.

Conclusions: In typical MHs, retinal sensitivity is impaired within a 3° range, with recovery observed at 3 months. The larger the hole, the greater the decrease in sensitivity at each point.